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General NPI Number Information
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NPI Number | 1144614975
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Entity Type | Organization
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Legal Business Name | HOLISTIC HOME CARE HOME HEALTH LLC
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Dates
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Enumeration Date | 03/18/2015
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Last Update Date | 03/18/2015
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Provider Practice Location Address
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Address Line | 102 S.E. MAIN ST.
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City | KEOTA
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State | OK
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Zip | 74941
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Country | US
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Telephone | 918-966-3356
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Fax | 918-966-3362
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Provider Business Mailing Address
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Address Line | P.O. BOX 100
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City | KEOTA
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State | OK
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Zip | 74941
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Country | US
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Telephone | 918-966-3356
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Fax | 918-966-3362
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Authorized Official
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Title or Position | ADMINISTRATOR/RN
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Name | JEANNE BISHOP
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Credential |
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Telephone | 918-966-3356
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | HC8043
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License Number State | OK
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